Role of contrast-enhanced ultrasonography in the management of chronic inflammatory bowel disease.

The incidence of inflammatory bowel disease (IBD) has increased over the past few decades. Also, the management of patients with IBD is associated with a relevant use of healthcare resources, and requires a multidisciplinary approach, with patients being cared for in monographic units. The umbrella term IBD includes ulcerative colitis (UC) and Crohn's disease (CD). The former condition involves the colonic mucosa alone, from the rectum in a cephalad direction with a variable extent, whereas the latter is a segmental transmural condition that may involve any portion of the gastrointestinal (GI) tract. Ileocolonoscopy is the gold standard for the diagnosis and follow-up of IBD, but can only assess intraluminal findings, hence it must be supplemented with techniques capable of transmural evaluation and of exploring scarcely accessible bowel segments, namely gastrointestinal ultrasound (GIUS), computed tomography (CT), and MR enterography (MRE).

Polymorphisms in Receptors Involved in Opsonic and Nonopsonic Phagocytosis, and Correlation with Risk of Infection in Oncohematology Patients.

High-risk hematological malignancies are a privileged setting for infection by opportunistic microbes, with invasive mycosis being one of the most serious complications. Recently, genetic background has emerged as an unanticipated risk factor. For this reason, polymorphisms for genes encoding archetypal receptors involved in the opsonic and nonopsonic clearance of microbes, pentraxin-3 (PTX3) and Dectin-1, respectively, were studied and correlated with the risk of infection. Fungal, bacterial, and viral infections were registered for a group of 198 patients with high-risk hematological malignancies. Polymorphisms for the pentraxin-3 gene (PTX3) showed a significant association with the risk of fungal infection by Candida spp. and, especially, by Aspergillus spp. This link remained even for patients undergoing antifungal prophylaxis, thus demonstrating the clinical relevance of PTX3 in the defense against fungi. CLEC7A polymorphisms did not show any definite correlation with the risk of invasive mycosis, nor did they influence the expression of Dectin-1 isoforms generated by alternative splicing. The PTX3 mRNA expression level was significantly lower in samples from healthy volunteers who showed these polymorphisms, although no differences were observed in the extents of induction elicited by bacterial lipopolysaccharide and heat-killed Candidaalbicans, thus suggesting that the expression of PTX3 at the start of infection may influence the clinical outcome. PTX3 mRNA expression can be a good biomarker to establish proper antifungal prophylaxis in immunodepressed patients.

Infectious crystalline keratopathy caused by Pseudomonas fluorescens.

OBJECTIVE: To demonstrate a case of infectious crystalline keratopathy (ICK) caused by Pseudomonas fluoresecens (PF). METHODS: Case report description. RESULTS: A 15-year-old female contact lens wearer presented complaining of eye pain and redness in the left eye. The patient reported that she had suffered a corneal scratch a few months earlier, which was treated by her family physician, and that she had felt some discomfort since then. The biomicroscopy showed a central corneal abscess with a crystalline appearance, stromal edema, the Tyndall effect, and abundant fibrin in the anterior chamber. A diagnosis of ICK was made. The culture was positive for gram-negative PF. Pseudomonas fluoresecens was sensitive to cephalosporins, quinolones, and tobramycin. CONCLUSIONS: No cases of ICK caused by PF have been reported previously. Two previous studies reported that the gram-negative Pseudomonas aeruginosa caused ICK. Unlike other ICK cases in which there is minimal stromal inflammation, the patient presented with an intense inflammatory reaction in the anterior chamber.

Impact of acetylation process of kraft lignin in development of environment-friendly semisolid lubricants.

The aim of this work was to study the influence of the acetylation process of kraft lignin on developing dispersions potentially applicable as new bio-based semisolid lubricants. Lignin was functionalized with acetic anhydride and pyridine as a catalyst by modifying different reaction variables (temperature, ratio of pyridine/acetic anhydride and time). Acetylated lignin was analyzed using FTIR, 1H and 13C NMR techniques, TGA, DSC and SEM to evaluate the chemical, morphological and thermal changes induced by the acetylation process. The influence of the acetylation process on the rheological and tribological properties of dispersions was related to the development of different microstructures, which depend on chemical and morphological properties of acetylated lignin. In this sense, two different rheological behaviours (gel-like or fluid-like) were found to depend on the reaction time. From the experimental results obtained, it can be concluded that the acetylation process is a key issue to modulate rheological and morphological properties of dispersions, resulting in an effective method to improve the compatibility of lignin and castor oil. Acetylated lignin with medium degrees of substitution with adequate morphological properties can be potentially used as an effective thickening agent to develop semisolid lubricants.

Improving the structure and properties of whey protein emulsion gel using soluble interactions with xanthan and basil seed gum.

Applying hydrocolloids in the structure of protein emulsion gel can improve its properties. Interaction of whey protein concentrate (WPC) (5%) with xanthan gum (XG) and basil seed gum (BSG) at different concentrations (0.2%, 0.4%, and 0.6%) was investigated to improve mechanical and structural properties of emulsion gel. Results illustrated that gums created a stronger structure around the oil droplets, which confocal images approved it. Also, the particle size decreased and uniformed by cooperating 0.6% gum in comparison with WPC (46.87 µm). The lowest and highest hardness values were observed in emulsion gel formed by WPC (1.27 N) and 0.6BSG: WPC (3.03 N), respectively. Also, the increase of gum concentration had a positive on consistency parameter of texture, so the value was 11.48 N s in WPC emulsion gel and it reached 0.6BSG: WPC (25.71 N s) and 0.6XG: WPC (19.96 N s). Evaluating the stability of the treatments by centrifugation indicated that 0.6BSG: WPC (89.10%) and 0.6XG: WPC (74%) had the highest level of stability. Increasing gum concentration increased the consistency and viscosity. Also, the viscoelastic properties of emulsion gel improved by 0.6% BSG. The elastic modulus of the WPC, 0.6XG: WPC, and 0.6BSG: WPC emulsion gels at the same frequency (1 Hz) was 240.90, 894.59, and 1185.61 Pa, respectively. In general, the interaction of WPC solution with hydrocolloids, especially BSG, is suggested to prepare more stable and elastic emulsion gels.

Our experience in the short-term diagnostic-therapeutic management of the patient with anal dysplasia.

INTRODUCTION: Anal intraepithelial neoplasia (AIN) is a premalignant lesion of anal squamous cell carcinoma. HIV-positive males who have sex with males, are the most affected at-risk population. Cytology and anuscopy are the best accepted methods for its diagnosis, although it is controversial which patients should complete it with a biopsy. Neither which patients should undergo treatment nor which is the best treatment is not well established. With this study, we would like to present our experience in the diagnostic-therapeutic management of AIN in the short term. METHODS: Retrospective observational study of patients at risk of AIN with altered anal cytology who underwent high-resolution anuscopy with biopsy. After histological confirmation of dysplasia, they started treatment with trichloroacetic acid. Its effectiveness was verified by subsequent cytology. The demographic variables of the sample and the results of both diagnostic and treatment tests were analyzed. RESULTS: The majority were HIV-positive males (104/115) and 50% had sexual relations with other men. We included 115 patients with altered anal cytology, of whom 92% had dysplasia on biopsy. 97% with atypia of uncertain significance on cytology had histological dysplasia. Cytology normalized after treatment in 60% of patients. CONCLUSION: Early detection of AIN should be routinely considered in known at-risk populations. Any cytological abnormality should be biopsied. Tricholoroacetic acid can be an effective treatment achieving a high percentage of regression, although currently, the information we have is of low level of evidence.

Impact of the Morphology of Electrospun Lignin/Ethylcellulose Nanostructures on Their Capacity to Thicken Castor Oil.

This study reports on a novel strategy for manufacturing thickened gel-like castor oil formulations by dispersing electrospun lignin/ethylcellulose nanostructures. These thickened formulations were rheologically and tribologically evaluated with the aim of being proposed as alternative ecofriendly lubricating greases. Low-sulfonate kraft lignin (LSL) and ethylcellulose (EC) were dissolved in a DMAc:THF mixture at different concentrations (8, 10, and 15 wt.%) and LSL:EC ratios (50:50, 70:30, and 90:10) and subjected to electrospinning. The resulting electrospun nanostructures were morphologically characterized. EC acting as the cospinning polymer improved both LSL spinnability and the oil structuring ability. Solutions with a high lignin content achieved microsized particles connected by fibrils, whereas solutions with a high EC content (50:50 ratio) and LSL/EC total concentration (10 and 15 wt.%) yielded beaded or bead-free nanofibers, due to enhanced extensional viscoelastic properties and nonNewtonian characteristics. The gel-like properties of electrospun nanostructure dispersions in castor oil were strengthened with the nanostructure concentration and the EC:LSL ratio, as a result of the formation of a more interconnected fiber network. The oleodispersions studied exhibited a satisfactory frictional response in a tribological contact, with friction coefficient values that were comparable to those achieved with traditional lithium-lubricating greases.

Refractive outcome after severe Pseudomonas aeruginosa Keratitis.

A 15-year-old myopic female contact lens wearer developed severe central corneal keratitis in the left eye caused by Pseudomonas aeruginosa. A rapid diagnosis and treatment led to a satisfactory response, although a gray central corneal scar, hyperopia, and visual loss remained. No surgery was required after the infection resolved, and the patient was assessed annually. Sixty-four months later, the cornea was almost totally transparent and she had a visual acuity of 20/20. The results of the topographical examination were similar to those after a refractive ablative procedure. Satisfactory refractive outcome after severe Pseudomonas aeruginosa keratitis may occur in extraordinary cases.

Electrospun lignin-PVP nanofibers and their ability for structuring oil.

This work explores the electrospinnability of low-sulfonate Kraft lignin (LSL)/polyvinylpyrrolidone (PVP) solutions in N,N-dimethylformamide (DMF) and the ability of the different micro- and nano-architectures generated to structure castor oil. LSL/PVP solutions were prepared at different concentrations (8-15 wt%) and LSL:PVP ratios (90:10-0:100) and physico-chemically and rheologically characterized. The morphology of electrospun nanostructures mainly depends on the rheological properties of the solution. Electrosprayed nanoparticles or micro-sized particles connected by thin filaments were obtained from solutions with low LSL/PVP concentrations and/or high LSL:PVP ratios, whereas beaded or bead-free nanofibers were produced by increasing concentration and/or decreasing LSL:PVP ratio, due to enhanced extensional viscoelastic properties and non-Newtonian characteristics. Electrospun LSL/PVP nanofibers are able to form oleogels by simply dispersing them into castor oil at concentrations between 10 and 30 wt%. The rheological properties of the oleogels may be tailored by modifying the LSL:PVP ratio and nanofibers content. The potential application of these oleogels as bio-based lubricants was also explored in a tribological cell. Satisfactory friction and wear results are achieved when using oleogels structured by nanofibers mats with enhanced gel-like properties as lubricants. Overall, electrospinning of lignin/PVP solutions can be proposed as a simple and effective method to produce nanofibers for oil structuring.

Cyttaria hariotii E.Fisch. as a promising source of pullulan and Mn(II)-pullulan complexes for Mn-deficiency remediation in winter cereals.

Pullulan, a water-soluble polysaccharide consisting of maltotriose units used in the preparation of edible films and drug delivery, is generally produced from starch by Aureobasidium pullulans (de Bary & Löwenthal) G.Arnaud fungus. In this article, the characterisation of an alternative pullulan source - the stromata of Cyttaria hariotii E.Fisch. fungus - by elemental analysis, infrared spectroscopy and thermal analysis techniques is reported. With a view to a possible valorisation of this pullulan and its derivatives as bioactive formulations in agriculture, low-molecular-weight pullulan (<7 kDa) complexes with Mn(II), suitable for the remediation of Mn-deficiencies in winter cereal by foliar application, were synthesised and characterised by mass spectrometry.

Effects of 6-Month Multimodal Physical Exercise Program on Bone Mineral Density, Fall Risk, Balance, and Gait in Patients with Alzheimer's Disease: A Controlled Clinical Trial.

We aimed to determine the short- and medium-term effects of a multimodal physical exercise program (MPEP) on bone health status, fall risk, balance, and gait in patients with Alzheimer's disease. A single-blinded, controlled clinical trial was performed where 72 subjects were allocated in a 3:1 ratio to an intervention group (IG; n = 53) and control group (CG; n = 19), where the IG's subjects were admitted to live in a State Reference Center of Alzheimer's disease, which offers the targeted exercise program, while the CG's subjects resided in independent living. A multidisciplinary health team assessed all patients before allocation, and dependent outcomes were again assessed at one, three, and six months. During the study, falls were recorded, and in all evaluations, bone mineral density was measured using a calcaneal quantitative ultrasound densitometer; balance and gait were measured using the performance-oriented mobility assessment (POMA), the timed up and go test (TUG), the one-leg balance test (OLB), and the functional reach test (FR). There were no differences between groups at baseline for all outcome measures. The prevalence of falls was significantly lower in the IG (15.09%) than in the CG (42.11%) (χ2 = 5.904; p = 0.015). We also found that there was a significant time*group interaction, with a post hoc Sidák test finding significant differences of improved physical function, especially in gait, for the IG, as assessed by POMA-Total, POMA-Gait, and TUG with a large effect size (ƞ2p = 0.185-0.201). In balance, we found significant differences between groups, regardless of time, and a medium effect size as assessed by POMA-Balance and the OLB (ƞ2p = 0.091-0.104). Clinically relevant effects were observed, although without significant differences in bone health, with a slowing of bone loss. These results show that a multimodal physical exercise program reduces fall risk and produces an improvement in gait, balance, and bone mineral density in the short and medium term in institutionalized patients with Alzheimer's disease.

Effects of Postharvest Water Deficits on the Physiological Behavior of Early-Maturing Nectarine Trees.

The physiological performance of early-maturing nectarine trees in response to water deficits was studied during the postharvest period. Two deficit irrigation treatments were applied, moderate and severe, and these were compared with a control treatment (fully irrigated). Stem water potential and leaf gas exchange (net CO2 assimilation rate, ACO2; transpiration rate, E; and stomatal conductance, gs) were measured frequently. Drought avoidance mechanisms included a decrease in stomatal conductance, especially in the case of the severe deficit treatment, which also showed a strong dependence of ACO2 on gs. Intrinsic water-use efficiency (ACO2/gs) was more sensitive than instantaneous water-use efficiency (ACO2/E) as an indicator to detect water deficit situations in nectarine trees. However, in contrast to the results obtained for other deciduous fruit trees, a poor correlation was found between ACO2/E and ACO2/gs, despite the important relation between E and gs. ACO2/E was also weakly correlated with gs, although this relationship clearly improved when the vapor pressure deficit (VPD) was included, along with gs as the independent variable. This fact reveals that apart from stomatal closure, E depends on the boundary layer conductance (gb), which is mediated by VPD through changes in wind speed. This suggests low values of the decoupling coefficient for this water-resilient species.

Antifungal Agents Based on Chitosan Oligomers, ε-polylysine and Streptomyces spp. Secondary Metabolites against Three Botryosphaeriaceae Species.

Grapevine trunk diseases (GTDs) are a major threat to the wine and grape industry. The aim of the study was to investigate the antifungal activity against Neofusicoccum parvum, Diplodia seriata, and Botryosphaeria dothidea of ε-polylysine, chitosan oligomers, their conjugates, Streptomyces rochei and S. lavendofoliae culture filtrates, and their binary mixtures with chitosan oligomers. In vitro mycelial growth inhibition tests suggest that the efficacy of these treatments, in particular those based on ε-polylysine and ε-polylysine:chitosan oligomers 1:1 w/w conjugate, against the three Botryosphaeriaceae species would be comparable to or higher than that of conventional synthetic fungicides. In the case of ε-polylysine, EC90 values as low as 227, 26.9, and 22.5 µg·mL-1 were obtained for N. parvum, D. seriata, and B. dothidea, respectively. Although the efficacy of the conjugate was slightly lower, with EC90 values of 507.5, 580.2, and 497.4 µg·mL-1, respectively, it may represent a more cost-effective option to the utilization of pure ε-polylysine. The proposed treatments may offer a viable and sustainable alternative for controlling GTDs.

Cembrane diterpenes from the gorgonian Leptogorgia laxa.

The new cembrane diterpenes leptodienone A (2) and leptodienone B (3) and the known compounds lopholide, lophodiol B, lophodione, and lophotoxin (1) have been isolated from the gorgonian Leptogorgia laxa collected in the Gulf of California. The structures of the new metabolites have been established by spectroscopic techniques. The in vitro cytotoxicity of the new compounds has been tested against three human tumor cell lines.

Evaluation of the Ex-PRESS(®) P-50 implant under scleral flap in combined cataract and glaucoma surgery.

AIM: To evaluate the efficacy and safety of glaucoma drainage device Ex-PRESS(®) P-50 for combined cataract surgery and glaucoma. METHODS: Patients having cataract and open angle glaucoma or patients with open advanced glaucoma which needed two or more antiglaucoma medications were included. Combined cataract surgery and glaucoma with Ex-PRESS(®) P-50 model placed under scleral flap was performed. RESULTS: Out of 40 eyes of 40 patients (55% male and 45% female) completed the study during one-year follow-up. The mean of age was 76.6±11.02y. The intraocular pressure (IOP) decreased significantly during the 12-month follow-up from 23.5 mm Hg to 16.8 mm Hg (Wilcoxon signed ranks test, P<0.001). A 59.5% of patients did not need any topical treatment, 10.8% of them needed one active principle, 27% needed two active principles, and 2.7% of them needed three active principles for successful IOP control (<21 mm Hg). CONCLUSION: Combined surgery of phacoemulsification with ExPRESS(®) P-50 lowers IOP from the preoperative baseline and reduces significantly the number of antiglaucoma active principles for IOP control after the operation.

Late postoperative capsular block syndrome: a case series studied before and after Nd:YAG laser posterior capsulotomy.

PURPOSE: To evaluate the clinical characteristics of the unusual late postoperative capsular block syndrome (CBS) and the effect of Nd:YAG laser posterior capsulotomy on visual acuity and refractive error as well as its possible complications. METHODS: In this retrospective cohort study, 12 eyes of 11 patients with late CBS who had undergone Nd:YAG laser posterior capsulotomy were reviewed. A complete ophthalmic examination including Scheimpflug camera and anterior segment optical coherence tomography (AS-OCT) imaging had been performed before and after posterior capsulotomy. RESULTS: The mean time between cataract surgery and posterior capsulotomy was 4.7 ± 1.5 years (range 3-9 years). Best-corrected visual acuity increased in 11 cases (91.7%). Only one eye showed a 0.5-D hyperopic shift following posterior capsulotomy. There were no postlaser complications such as increased intraocular pressure (IOP), severe inflammation, cystoid macular edema, or retinal detachment. In all patients, the posterior capsule was vaulted posteriorly and could not be seen clearly. The AS-OCT confirmed CBS in the studied cases, demonstrating a distended capsular bag. Rotating Scheimpflug imaging examination showed the white substance located behind the intraocular lens (IOL). CONCLUSIONS: Late CBS is usually not accompanied by shallow anterior chamber, forward IOL displacement, or raised IOP. Nd:YAG laser posterior capsulotomy is a useful treatment and the prognosis of patients with this complication appears favorable. Furthermore, although AS-OCT measurements are easier to obtain than rotating Scheimpflug imaging examination, both are useful to visualize the distended capsular bag containing the white material and the IOL position.

Profound blockade of T cell activation requires concomitant inhibition of different class I PI3K isoforms.

PI3K inhibitors have emerged as potential therapeutic tools for a variety of diseases, and thus, a vast array of compounds with specificity for different PI3K isoforms is being developed. Gaining knowledge about the contribution of the different isoforms to PI3K function will allow selecting the most appropriate inhibitor for each pathology. In this study, we have addressed the effect of PI3K inhibitors with specificity for different class I PI3K isoforms on primary human T cell activation. In particular, we have analyzed proliferation, expression of activation and differentiation markers, apoptosis induction, cytokine secretion and Akt phosphorylation in T cells stimulated in vitro with anti-CD3 and anti-CD28 monoclonal antibodies and cultured with either one of these compounds: p110ß-specific inhibitor TGX-221, p110δ-specific inhibitor IC-87114, p110γ inhibitor AS-242525 or pan-class I PI3K inhibitor BKM120. Inhibition of any of the isoforms led to an impairment of T cell activation, mainly of cytokine secretion and granzyme B expression. However, only complete blockade of class I PI3K activity with the pan-class I inhibitor effectively abrogated T cell proliferation. These results indicate that these three p110 isoforms (ß, δ and γ) take part in T cell activation, but all of them are dispensable for T cell proliferation.